Skip to main content
Log in

Understanding the Quality of Life for Parents and Their Children Who have Asthma: Family Resources and Challenges

  • Original Paper
  • Published:
Contemporary Family Therapy Aims and scope Submit manuscript

Abstract

In this study we investigated the links between caregiver burden, family environment, and quality of life in 97 pairs of children with asthma and the one who was determined to be the primary family caregiver. Using structural equation modeling, within-participant analyses showed that family environment was positively linked to quality of life for both children and parents. Across-participant analyses demonstrated that parents’ positive perceptions of family environment were associated with parents’ and children’s improved quality of life. In addition, parents’ perceptions of family environment mediated the link between caregiver burden and parents’ and children’s quality of life. Implications for intervention with families are discussed in light of this study’s important results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

Notes

  1. For simplicity, we opted to use the term children when referring to this study’s sample comprised of both children and adolescents.

References

  • Anderson, J. C., & Gerbing, D. W. (1988). Structural equation modeling in practice: A review and recommended two step approach. Psychological Bulletin, 103, 411–423.

    Article  Google Scholar 

  • Annett, R. D., Turner, C., Brody, J. L., Sedillo, D., & Dalen, J. (2010). Using structural equation modeling to understand child and parent perceptions of asthma quality of life. Journal of Pediatric Psychology, 35(8), 870–882.

    Article  PubMed  Google Scholar 

  • Arbuckle, J. L. (2007). Amos 16.0 user’s guide. Chicago, IL: SPSS Inc.

    Google Scholar 

  • Barlow, J. H., & Ellard, D. R. (2006). The psychosocial well-being of children with chronic disease, their parents and siblings: An overview of the research evidence base. Child: Care, Health and Development, 32, 19–31.

    Article  Google Scholar 

  • Barros, L., Matos, M. G., & Batista-Foguet, J. M. (2008). Chronic diseases, social context and adolescent health. Revista Brasileira de Terapias Cognitivas, 4, 123–141.

    Google Scholar 

  • Brown, E., Gan, V., Jeffress, J., Mullen-Gingrich, K., Khan, D., Wood, B., et al. (2006). Psychiatric symptomatology and disorders in caregivers of children with asthma [Electronic Version]. Pediatrics, 118, 1715–1720.

    Article  Google Scholar 

  • Brown, E., Gan, V., Jeffress, J., Wood, B., & Mille, B. (2008). Antidepressant treatment of caregivers of children with asthma. Psychosomatics, 49, 420–425.

    Article  PubMed  Google Scholar 

  • Canning, R. D., Harris, E. S., & Kelleher, K. J. (1996). Factors predicting distress among caregivers to children with chronic medical conditions. Journal of Pediatric Psychology, 21, 735–749.

    Article  PubMed  Google Scholar 

  • Clawson, J. A. (1996). A child with chronic illness and the process of family adaptation. Journal of Pediatric Nursing, 11, 52–61.

    Article  PubMed  Google Scholar 

  • De Lira & Da Silva (2005). Qualidade de vida em pacientes pediátricos com asma: Perspectiva dos pais por meio do Child Health Questionnaire (CHQ-PF50). Manuscrito não publicado.

  • European DISABKIDS Group. (2006). The DISABKIDS questionnaires for children with chronic conditions: Handbook. Lengerich: Pabst Science Publishers.

    Google Scholar 

  • Everhart, R., & Fiese, B. (2009). Asthma severity and child quality of life in pediatric asthma: A systematic review. Patient Education and Counseling, 75, 162–168.

    Article  PubMed  Google Scholar 

  • Everhart, R. S., Fiese, B. H., & Smyth, J. M. (2008). A cumulative risk model predicting caregiver quality of life in pediatric asthma. Journal of Pediatric Psychology, 33, 809–818.

    Article  PubMed  Google Scholar 

  • Fiese, B. H., Wamboldt, F. S., & Anbar, R. D. (2005). Family asthma management routines: Connections to medical adherence and quality of life. Journal of Pediatrics, 146, 171–176.

    Article  PubMed  Google Scholar 

  • Fiese, B. H., Winter, M., Anbar, R., Howell, K., & Poltrock, S. (2008). Family climate of routine asthma care: Associating perceived burden and mother-child interaction patterns to child well-being. Family Process, 47, 63–79.

    Article  PubMed  Google Scholar 

  • Frankel, K., & Wamboldt, M. Z. (1998). Chronic childhood illness and maternal mental health: Why should we care? Journal of Asthma, 35, 621–630.

    Article  PubMed  Google Scholar 

  • Gaspar, T., & Matos, M. G. (Eds.). (2008). Qualidade de vida em crianças e adolescentes: Versão portuguesa dos instrumentos KIDSCREEN-52. Cruz Quebrada: Aventura Social e Saúde.

    Google Scholar 

  • Global Initiative for Asthma [GINA]. (2008). Global strategy for asthma management and preventionupdated 2008. Retrieved from http://www.ginasthma.org.

  • Goldbeck, L. (2006). The impact of newly diagnosed chronic pediatric conditions on parental quality of life. Quality of Life Research, 15, 1121–1131.

    Article  PubMed  Google Scholar 

  • Hesselink, A. E., Penninx, B. W., Schlösser, M. A., Wijnhoven, H. A., van der Windt, D. A., Kriegsman, D. M. W., et al. (2004). The role of coping resources and coping style in quality of life of patients with asthma or COPD. Quality of Life Research, 13, 509–518.

    Article  PubMed  Google Scholar 

  • Horton, T. V., & Wallander, J. L. (2001). Hope and social support as resilience factors against psychological distress of mothers who care for children with chronic physical conditions. Rehabilitation Psychology, 46, 382–399.

    Article  Google Scholar 

  • Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55.

    Article  Google Scholar 

  • Josie, K., Greenley, R., & Drotar, D. (2007). Cumulative risk and asthma outcomes in inner-city African–American youth. Journal of Asthma, 44, 535–541.

    Article  PubMed  Google Scholar 

  • Kaugars, A. S., Klinnert, M. D., & Bender, B. G. (2004). Family influences on pediatric asthma. Journal of Pediatric Psychology, 29, 475–491.

    Article  PubMed  Google Scholar 

  • Kazak, A. E. (1987). Families with disabled children: Stress and social networks in three samples. Journal of Abnormal Child Psychology, 15, 137–146.

    Article  PubMed  Google Scholar 

  • Kazak, A. E. (1989). Families of chronically ill children: A systems and socio-ecological model of adaptation and challenge. Journal of Consulting and Clinical Psychology, 57, 25–30.

    Article  PubMed  Google Scholar 

  • Kline, R. B. (2005). Principles and practice of structural equation modeling. New York: Guilford Press.

    Google Scholar 

  • Klinnert, M., McQuaid, E., McCormick, D., Adinoff, A., & Bryant, N. (2000). A multimethod assessment of behavioral and emotional adjustment in children with asthma. Journal of Pediatric Psychology, 25, 35–46.

    Article  PubMed  Google Scholar 

  • Krulik, T., Turner-Henson, A., Kanematsu, Y., Al-Ma’aitah, R., Swan, J., & Holaday, B. (1999). Parenting stress and mothers of young children with chronic illness: A cross-cultural study. Journal of Pediatric Nursing, 14, 130–140.

    Article  PubMed  Google Scholar 

  • Laursen, B., & Collins, W. A. (2009). Parent-child relationships during adolescence. In R. M. Lerner & L. Steinberg (Eds.), Handbook of adolescent psychology: Contextual influences on adolescent development (3rd ed., Vol. 2, pp. 3–42). New York: Wiley.

    Google Scholar 

  • MacKinnon, D. P., Lockwood, C. M., & Williams, J. (2004). Confidence limits for the indirect effect: Distribution of the product and resampling methods. Multivariate Behavioral Research, 39, 99–128.

    Article  PubMed  Google Scholar 

  • Mailick, M., Holden, G., & Walther, V. (1994). Coping with childhood asthma: Caretakers views. Health and Social Work, 19, 103–111.

    PubMed  Google Scholar 

  • Marks, N. F., & Greenfield, E. A. (2008). The influence of family relationships on adult psychological well-being and generativity. In M. C. Smith & N. DeFrates-Densch (Eds.), The handbook of research on adult learning and development (pp. 303–347). New York: Routledge.

    Google Scholar 

  • Markson, S., & Fiese, B. H. (2000). Family rituals as a protective factor for children with asthma. Journal of Pediatric Psychology, 25, 471–479.

    PubMed  Google Scholar 

  • Marsac, M. L., Funk, J. B., & Nelson, L. (2006). Coping styles, psychological functioning and quality of life in children with asthma. Child: Care, Health and Development, 33, 360–367.

    Article  Google Scholar 

  • Matos, P. M., & Fontaine, M. (1992). Family environment scaleFES. Adaptação portuguesa. Unpublished manuscript. Porto: Faculdade de Psicologia e de Ciências da Educação da Universidade do Porto.

  • Minuchin, S., Rosman, B., & Baker, L. (1978). Psychosomatic families: Anorexia in context. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Montgomery, R. J., Borgatta, E. F., & Borgatta, M. L. (2000). Societal and family change in the burden of care. In W. T. Liu & H. Kendig (Eds.), Who should care for the elderly? An east–west divide (pp. 27–54). Singapore: The National University of Singapore Press.

    Chapter  Google Scholar 

  • Moonie, S., Sterling, D., Figgs, L., & Castro, M. (2008). The relationship between school absence, academic performance and asthma status. The Journal of School Health, 78, 140–148.

    Article  PubMed  Google Scholar 

  • Moos, R. H., & Moos, B. S. (1986). Family environment scale manual (2nd ed.). Palo Alto, CA: Consulting Psychologists Press.

    Google Scholar 

  • Pinquart, M., & Sörensen, S. (2003). Associations of stressors and uplifts of caregiving with caregiver burden and depressive mood: A meta-analysis. Journal of Gerontology: Psychological Sciences, 58, 112–128.

    Google Scholar 

  • Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40, 879–891.

    Article  PubMed  Google Scholar 

  • Quittner, A. L., Glueckauf, R. L., & Jackson, D. N. (1990). Chronic parenting stress: Moderating vs. mediating effects of social support. Journal of Personality and Social Psychology, 59, 1266–1278.

    Article  PubMed  Google Scholar 

  • Quittner, A. L., Opipari, L. C., Regoli, M. J., Jacobsen, J., & Eigen, H. (1992). The impact of caregiving and role strain on family life: Comparisons between mothers of children with cystic fibrosis and matched controls. Rehabilitation Psychology, 37, 275–290.

    Article  Google Scholar 

  • Raina, P., O’Donnell, M., Schwellnus, H., Rosenbaum, P., King, G., Brehaut, J., et al. (2004). Caregiving process and caregiving burden: Conceptual models to guide research and practice. Pediatrics, 4, 1–13.

    PubMed  Google Scholar 

  • Ravens-Sieberer, U., Erhart, M., Rajmil, L., Herdman, M., Auquier, P., Bruil, J., et al. (2010). Reliability, construct and criterion validity of the KIDSCREEN-10 score: a short measure for children and adolescents’ well-being and health-related quality of life. Quality of Life Research. Retrieved October, 27, 2010, from http://www.ncbi.nlm.nih.gov/pubmed. doi: 10.1007/s11136-010-9706-5O.

  • Sales, J., Fivush, R., & Teague, G. W. (2008). The role of parental coping in children with asthma’s psychological well-being and asthma-related quality of life. Journal of Paediatric Psychology, 33, 208–219.

    Article  Google Scholar 

  • Sameroff, A. J., & Fiese, B. H. (2000). Models of development and developmental risk. In C. H. Zeanah Jr. (Ed.), Handbook of infant mental health (2nd ed., pp. 3–19). New York: Guilford Press.

    Google Scholar 

  • Shohat, T., Graif, Y., Garty, B., Livne, I., & Green, M. S. (2005). The child with asthma at school: Results from a national asthma survey among schoolchildren in Israel. Journal of Adolescent Health, 37, 375–380.

    Article  Google Scholar 

  • Silver, E. J., Westbrook, L. E., & Stein, R. E. K. (1998). Relationship of parental psychological distress to consequences of chronic health conditions in children. Journal of Pediatric Psychology, 23, 5–15.

    Article  PubMed  Google Scholar 

  • Streisand, R., & Tercyak, K. P. (2004). Parenting children with physical and medical problems. In N. Long & M. Hoghughi (Eds.), Handbook of parenting: Theory, research, and practice (pp. 181–197). London, UK: Sage.

    Google Scholar 

  • Thornton, N., Hamiwka, L., Sherman, E., Tse, E., Blackman, M., & Wirrell, E. (2008). Family function in cognitively normal children with epilepsy: Impact on competence and problem behaviors. Epilepsy & Behavior, 12, 90–95.

    Article  Google Scholar 

  • Turner-Henson, A., Holaday, B., & Swan, J. H. (1992). When parenting becomes caregiving: Caring for the chronically ill child. Family & Community Health, 15, 19–30.

    Google Scholar 

  • Van Gent, R., Van Essen, L. E., Rovers, M. M., Kimpen, J. L., Van der Ent, C. K., & Meer, G. (2007). Quality of life in children with undiagnosed and diagnosed asthma. European Journal of Pediatrics, 166, 843–848.

    Article  PubMed  Google Scholar 

  • Vaz-Serra, A., Canavarro, M. C., Simões, M. R., Pereira, M., Gameiro, S., Quartilho, M. J., et al. (2006). Estudos psicométricos do instrumento de avaliação da qualidade de vida da Organização Mundial de Saúde (WHOQOL-Bref) para português de Portugal. Psiquiatria Clínica, 27(1), 41–49.

    Google Scholar 

  • Vila, G., Hayder, R., Bertrand, C., Falissard, B., De Blic, J., Mouren-Simeoni, M., et al. (2003). Psychopathology and quality of life for adolescents with asthma and their parents. Psychosomatics, 44, 319–328.

    Article  PubMed  Google Scholar 

  • Wallander, J. L., & Varni, J. W. (1989). Social support and adjustment in chronically ill and handicapped children. American Journal of Community Psychology, 17, 185–201.

    Article  PubMed  Google Scholar 

  • Waxmonsky, J., Wood, B., Stern, T., Ballow, M., Lillis, K., Cramer-Benjamin, D., et al. (2006). Association of depressive symptoms and disease activity in children with asthma: Methodological and clinical implications. Journal of the American Academy of Child and Adolescent Psychiatry, 45, 945–954.

    Article  PubMed  Google Scholar 

  • WHOQOL Group. (1998). Development of World Health Organization WHOQOL-BREF quality of life assessment. Psychological Medicine, 28, 551–558.

    Article  Google Scholar 

  • Wolf, J. M., Miller, G. E., & Chen, E. (2008). Parent psychological states predict changes in inflammatory markers in children with asthma and healthy children. Brain, Behavior, and Immunity, 22, 433–441.

    Article  PubMed  Google Scholar 

  • Wood, B. L., Lim, J., Miller, B., Cheah, P. A., Simmens, S., Stern, T., et al. (2007). Family emotional climate, depression, emotional triggering of asthma, and disease severity in pediatric asthma: Examination of pathways of effect. Journal of Pediatric Psychology, 32, 542–551.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Carla Crespo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Crespo, C., Carona, C., Silva, N. et al. Understanding the Quality of Life for Parents and Their Children Who have Asthma: Family Resources and Challenges. Contemp Fam Ther 33, 179–196 (2011). https://doi.org/10.1007/s10591-011-9155-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10591-011-9155-5

Keywords

Navigation